Travel Story (1): NPM and prisoners with mental disabilities
◎ Photo: Yi-Ching Tsai (The Prison Museum in Chiayi, Taiwan)
Author: Pavel Doubek (Czech scholar and lawyer formerly working at Czech NPM)[i]
The nature of the imprisonment goes hand in hand with the risks of torture and ill-treatment. Prisoners are subject to a number of involuntary measures (restrictions on free movement, the right to privacy, sanitary restrictions, restrictions on the right to choose a doctor, etc.), as well as to limited material equipment in places where they spend most of their time. The risk of ill-treatment is also increased by the complicated composition of the prison population that includes e.g. drug addicts, elderly people, people with a mental disability, chronically ill prisoners, etc. It’s not only because the prison often fails to accommodate the needs of different groups of prisoners, but also the Joint accommodation of, e.g. smokers with non-smokers, recidivists with those who are in prison for the first time, adults with juveniles, can lead to conflicts or even bullying between prisoners. That is why prevention of torture and ill-treatment in prisons is the core activity of the National Preventive Mechanism under the OPCAT.
Since its establishment in 2006, the Czech NPM has carried out 36 visits to prisons and reached thousands of prisoners. Currently, there are 35 prisons in the Czech Republic consisting of about 19,500 prisoners.NPM has spent considerable time and effort to ensure the visits are planned to cover the whole territory of the country through a representative sample of all facilities[ii], and cover all areas with risk of ill-treatment in prison facilities.
The general topics for the NPM visit include, for example, the assessment of the material conditions and prison capacity, provision of health-care, employment of correctional measures and prison regime measures, prevention of abuse and self-harm, protection of the privacy of prisoners and their contact with the outside world, and so forth. Like many other countries in other world, the Czech Republic was concerned with problems such as prison overcrowding, lack of specialized personnel, low rates of prisoners employment and low payment for their work, poor material conditions.
Vulnerable to harm: visiting prisoners with mental disabilities
In 2014, the NPM has conducted a series of visits to five prisons with a particular focus on the functioning of health-care services, especially with respect to imprisonment of people with various health disability (physical and mental). NPM has revealed a number of more or less serious shortcomings in these visits. In two prisons, we managed to gather enough evidence and demonstrated how these deficiencies had reached the level of ill-treatment[iii] that I would like to share with you since it relates not only to the human rights in prisons, but also poses a challenge to the meaning and purpose of imprisonment
Persons with disabilities are an extremely vulnerable group in the prisons for several reasons. Firstly, general medical care in most prisons is poor already, not to mention access to full-time psychiatrists and specialized rehabilitation professionals. Second, prisoners with disabilities are easy targets of abuse by their inmates, in particular when they need help (physical and hygienic support, drug delivery, etc.). Third, compared with others, disabilities often hinders the prisoners from participating in the corrective and re-socialization activities, which is an essential requirement for the courts when deciding on probation. All of these can lead to a deterioration in physical and mental health and self-harm or suicide attempts, with dim hope of social reintegration for the prisoners.
During the unannounced visits, the lawyers and medical experts of the NPM successfully gathered a huge sum of evidence, including interviews with prisoners, prison staff and officials, medical records, treatment programs, etc., and we revealed in the 2 prisons that some prisoners suffering from serious mental disabilities are placed in an ordinary prison ward without any mental health services and therapeutic activities. These persons were locked alone in a plain prison cell most of a day for several months. Although the prison staff tried for several times to improve the situation of these prisoners, due to their aggressive behaviour and inability to cooperate, they repeatedly end up in solitary where they did not benefit from either, individual or group activities, nor systematic therapeutic work provided by psychiatrists or other specialists.
After a careful evaluation of the seriousness of the prisoners´ disability, the absence of any therapeutic activities and long-term isolation in the cell with minimal contact with the prison’s professional staff, the Ombudsman (formal head of the NPM) issued a visit report and concluded that the treatment reached the intensity of ill-treatment. The NPM applied Art. 3 of the European Convention of Human Rights (prohibition of torture) and referred to an extensive case-law of the European Court of Human Rights[iv]that sets up the standards for incarceration of persons with mental disabilities and forbids the pure isolation of prisoners with mental disabilities without “appropriate treatment”.
The ultimate solution: toward a humane idea of imprisonment
Although these visits shed more light on the living conditions of people suffering from mental disability in Czech prisons, it is clearly not just the problem of an individual prison facility, but a systematic problem for the whole Czech prison system. Therefore, the NPM decided to address this issue in a systematic approach by joining in the ongoing domestic debate about how to introduce a new conception of designing the prison system in the Czech Republic, that is, to treat all prisoners in a humane way – consider them as a human being and respect their human dignity and rights.
In another special report, the NPM summarizes all the visits to prisons it has conducted and contains a set of recommendations addressed to Ministry of Justice and Directorate General of the Prison Service. Utilizing the knowledge and experience from visits in 2014, the NPM proceed to visit specialized prison wards intended for prisoners suffering from various disability. Between 2017 – 2018 the NPM visited, for a first time, the facilities known as “the preventive detention”, which lies on the intersection between prison and psychiatric hospital and is intended for criminals suffering from mental disorder. Let’s have a look at this specific type of detention in some next story.
Although the debate on the appropriate treatment with persons with disabilities in correctional facilities in the Czech Republic has not yet resulted in sufficient outcomes, it is the credit of the NPM that opened the prison to the public and brought the reliable data, so the discussion could be started.
Note
- This article is one of the NPM TRAVELBOOK series written by Mr Pavel Doubek and invited by Covenants Watch (CW), Taiwan. The original text was written in English and was translated by Yi-Ching Tsai, CW’s researcher. For more information about the column, please read the preface to the column.
- The visits involved all four types of prisons in the Czech Republic: (A) Minimum Security (open) Prisons, (B) Medium Security (semi-open) Prisons, (C) High Security (closed) Prisons and (D) Maximum Security Prisons
- Importantly, because the evaluation of torture and ill-treatment must be based on individual specifics, the team must be able to conduct case-by-case analysis whether a treatment is appropriate or not and if not, whether it crosses the threshold.
- e.g. the Judgements of Rivière v. France, Slawomir Musiał v. Poland, G. v. France. Since the ECtHR’s judgements have binding effect in domestic law, NPM recommendations in line with ECtHR´s case-law are more accepted by state authorities.